The impact of pathologic differentiation (well/ poorly) and the degree of Ki-67 index in patients with metastatic WHO grade 3 GEP-NECs.

Kim, Seung Tae,Lee, Su Jin,Lee, Jeeyun,Park, Joon Oh,Park, Young Suk,Lim, Ho Yeong,Kang, Won Ki Grune & Stratton 2017 Journal of clinical oncology Vol.35 No._suppl15

<P> e15686 </P><P> Background: Herein, we investigated the impact of pathologic differentiation (well or poorly differentiated) in metastatic grade 3 GEP-NEC patients receiving etoposide and platinum-based therapy. Simultaneously, we evaluated a more exact Ki67 index cut-off point to select patients with grade 3 GEP-NEC who might benefit from etoposide plus platinum (EP)-based therapy. Methods: Among patients pathologically diagnosed with metastatic grade 3 GEP-NECs at Samsung Medical Center between June 2013 and March 2016, 31 GEP-NEC patients receiving etoposide and platinum-based therapy were included in this study. Results: Primary sites included 13 foregut-derived GEP-NECs [stomach (n = 4), duodenum (n = 4), and pancreas (n = 5)] and 2 hindgut-derived GEP-NECs of the rectum. Sixteen unclassified GEP-NECs originated from 7 gall-bladder (GB), 6 liver and 3 unknown primary sites. According to pathologic differentiation, 14 patients had well differentiated and 17 had poorly differentiated grade 3 GEP-NECs. Between well differentiated and poorly differentiated grade 3 GEP-NECs, there was a significant difference in the distribution of Ki67 index. There was no significant difference of treatment efficacy between well and poorly differentiated grade 3 GEP-NECs (RR; 35.7% vs. 41.2%, p = 0.525). Tumor response to EP occurred in 5 of 7 patients with Ki67 > 60% and 7 of 24 with Ki67≤60%, which was significantly different (RR; 71.4% vs. 29.2%, P = 0.043). There was no significant difference in PFS according to pathologic differentiation (well differentiated vs. poorly differentiated) and Ki67 index ( > 60% vs ≤60%). Conclusions: Grade 3 GEP-NECs could be morphologically classified into well and poorly differentiated NETs. Additionally, among grade 3 GEP-NECs, there was a significant difference in ranges of Ki67 index between well and poorly differentiated NECs. Higher levels ( > 60%) of Ki67 index might be a predictive marker for efficacy of EP as a standard regimen in grade 3 GEP-NECs. </P>

Poster Session : PS 0831 ; Upper GI Tract : Clinical Factors to Predict Angiographically Detectable Non-Variceal Upper Gastrointestinal Bleeding in Patients Refractory to Endoscopic Treatment

( Tae Hwan Ha ),( Tae Hoon Oh ),( Sung In Yu ),( Min Kim ),( Jong Wook Kim ),( Won Ki Bae ),( Jae Hyung Kim ),( Seung Suk Baek ),( Mi Jin Ryu ),( Ye Na Choi ),( Ji Young Park ),( Eileen L Yoon ),( Tae 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Non-variceal upper GI bleeding (NVUGIB) is a common medical problem that has signifi cant association with morbidity and mortality. Angiographic detection and subsequent transarterial embolization (TAE) is a primary treatment option when medical and endoscopic treatments fail. We investigated clinical factors that could affect the success of the angiographic detection and prognosis after TAE in patients with NVUGIB refractory to endoscopic therapy. Methods: A retrospective analysis of the clinical data was done in patients with failed endoscopic treatment who underwent angiography for the treatment of acute NVUGIB between May 2002 and May 2013. Patients were divided into detection or non-detection groups according to the presence of bleeding stigmata in angiographic fi nding. Rebleeding defi ned as subsequent bleeding event within 7 days and mortality within 30days were analyzed as outcome parameters after TAE following detection in angiography. Results: A total 45 patients 37 (male, mean age, 65.9±14.9 years) were analyzed and classifi ed as a detection group (n=25, 55.5%) and non-detection group (n=20, 44.6%). Peptic ulcers were the most common cause of refractory NVUGIB. Larger transfusion amount (5.7±3.9 unit vs. 3.5±2.8 unit; P=0.03), prolonged aPTT level (34.2±17.3 sec vs. 21.8±13.8 sec; P=0.01) and short time interval between last endoscopy and angiography (17.5±25.9 hours vs. 34.3±59.5 hours; P=0.04) were found to be signifi cant factors for predicting angiographic detection. TAE was performed in all patients detected in angiography. Rebleeding (44%) was significantly associated with higher Rockall score (8.3±1.5 vs. 6.6±2.4; P=0.046) and mortality (12%) was signifi cantly associated with higher Rockall score (9.3±0.6 vs. 7.1±2.2; P=0.002) and higher level of BUN (55.3±47.4 vs. 27.6±17.4; P=0.01). Conclusions: Clinical characteristics associated with angiographic detection in patients with NVUGIB refractory to endoscopic therapy were severe bleeding, bleeding tendency and early angiographic intervention. The Rockall score is useful parameter for predicting rebleeding and mortality after TAE.

수돗물중 異臭味에 關한 硏究

김형석,이기태 慶熙大學校 1995 論文集 Vol.24 No.-

The taste and odor in city tap water could be a reason of discomfort by citizen. Even though the concentration of odor substances is trace amount in drinking water, human can detect with sensory system easily. The sources of taste fund odor come from anthropogenic activity and natural origin. Industrial wastewater could contain chemicals and chlorine taste comes from disinfection process during drinking water treatment. Natural sources are the algae and Streptomyces tendae which produce geosmin and 2-methylisoborneol. The numbers of actinomycetes in river water were found to increase coincidentally at the onset of spring. When more than one hundred actinomycetes isolates from water samples were tested for their ability to produce geosmin and 2-methylisoborneol(2-MIB), the majority were able to produce one of both of these odorous compounds. Cyanobacteria also could produce geosmin or 2-methylisoborneol and produce musty-odor. Gas chromatography/mass spectrometry(GC/MS) analyses indicated that volatile fractions of earthy/musty odor compounds are geosmin and 2-MIB. In the water purifying plants algae would make earthy and musty odor. In Japan 1,750 person were complained about the tap water odor. The area of odor problem are related with eutrophication, where the total phosphorous is more than 0.02㎎/L and total nitrogen is more than 0.6㎎/L. The odor of 2-MIB is produced by Phormidium tenue, Oscillatoria tenuis, and geosmin producing algae is produced by Anabaena macrospora and Anabaena spiroides var.crassa. Those 4 algae contain not only chlorophill, but phicocyanin. The detection method of geosmin and 2-MIB is difficult when sample is analyzed directly in GC, so we need to concentrate the sample in advance. Purge and trap method is one of the effective method. Authors tried to detect the geosmin and 2-MIB in drinking water by extracting the water sample in purge and trap methods and SPME(solid phase micro extraction) method was applied to detect benzene, toluene, and xylene. There are two kinds of sources for odor substances. One is fungus, e.g., Streptomyces tendae. Penicillium expansum, Actinomycetes, which produce geosmin. The other one is blue-green algae, e.g., Phormidium tenue, Oscillatoria limnetica, which produce 2-methylisoborneol. We could detect the geosmin and 2-methylisoborneol standard solution with gas chromatograph. The volatile organic coumpounds, BTEX, were detected with SPME(solid phase micro extraction) method.

포괄수가지불제도 적용에 따른 산부인과 진료수입의 변화

황태연,유병철,정귀언,정수진,김성준,배기택,손혜숙,이종태,전진호,엄상화 인제대학교 2001 仁濟醫學 Vol.22 No.1

Objectives: Under the fee-for-service system, Korean hospitals have been suffering from the worsening profitability caused by law medical care fees. To overcome the difficulties, they have maximized the quantity of medical services and made relatively large investment in developing new medical services using high-priced medical equipment, medicines and medical supplies which were not covered by medical insurance system rather than reduced running costs. Materials and Methods: This study was made to analyze and forecast the revenue change of the department of Obstetrics and gynecology of an university hospital in Seoul, expecting the implementation of DRG system in 2000. Results: The results were as follows : 1.During the first two days of hospitalization. 41% of total medical service fee was occurred, which was thought that most of the check-ups and operations were made during this period. After two days of hospitalization, the new occurrence of medical service fee tended to reduce. 2.Out of total medical service fee, 67% of admission fee was occurred after 5 days of hospitalization. This was because medical service fees in obstetrics and gynecology department occurred during the first 5 days of hospitalization. 3.Out of fees for operation, treatment, medical supplies and blood transfusion. 71% was occurred during the first two days. 4. In case of fees for examination, 50% was occurred during the first two days. 5.A total of 53% of fees for medication and injection was occurred during the first 5 days. Conclusions: By the implementation of the DRG system, the income is forecast to increase by 800 won to 310,000 won by the disease group of obstetrics and gynecology department. To increase hospital income with the implementation of DRG system, the results of this study suggest that examinations should be done at out-patient departments before the hospitalization of patient, the discharge of patient should be noticed in advance to reduce the period of hospitalization, and admission appointment system should be implemented for the immediate operation and delivery.

단측 및 양측뇌손상에 의한 인지장애

廉泰鎬,金基錫 漢陽大學校 精神健康硏究 1988 精神健康硏究 Vol.7 No.-

K 대학병원 서어비스에 대한 소비자 만족도

이태섭,박종원,이무식,윤능기,이충원,서석권 啓明大學校 醫科大學 1993 계명의대학술지 Vol.12 No.3

Authors administered a questionnaire to 300 clients visited to the K University Hospital during August in 1992 to investigate the degree and related factors of consumer's satisfaction with the hospital services. Clients consisted of 82 in-patients and 158 out-patients, 52.4 percent of them was male. Four dimensions of satisfaction were assessed which were medical management, administration, environment and attitude. In-patients reported as dissatisfied with the waiting time during receipt, investigative medical procedures and pharmacy (64.7%), lack of conveniency facilities for patients and their guardians(48.8%) and provision of conveniency facilities in the ward(42.4%), unsanitary state of out- and in-hospital(41.5%). Out-patients reported dissatisfaction with the course of medical management and the time needed(70.3%), the waiting time during receipt, investigative medical procedures and pharmacy(68.3%), lack of conveniency facilities for patients and guardians(42.4%). But both in-patients and out-patients were satisfied with medical equipments, doctor's diagnosis reliability and medical effects, technician's attitude more than 50%. Canonical correlation analysis was done to find related sociodemographic factors to the four dimensions of satisfaction. Of the four canonical functions, the first was only statistically significant in in-patients. Its eigen value was 0.56 and its canonical correlation coefficient was 0.60. Satisfaction with environment and medical management was selected as important concept in dependent variables. Standardized canonical function of environment and medical management were 0.76 and 0.35 respectively. It was related with woman with high educational attainment and increasing number of hospital visits. In out-patients, the first, second and third function were statistically significant and their eigen values were 0.18, 0.4, 0.08 respectively which were small compared to those of in-patients. Their canonical correlation coefficient were 0.40, 0.35, 0.28 respectively. Low degree of environment but high degree of medical management satisfaction was noted in the first function which was related with old age, woman and professional occupation. Low degree of satisfaction with administration(second function) was related with city resident, non-professional occupation and young age. High degree of medical management but low degree of administration satisfaction(third function) was related with surgical visitor, man and non-professional occupation. The direction of hospital managerial strategies could be planned and general characteristics of dissatisfactory clients might be suggested with these results.

경화된 열경화성 수지와 고분자재의 혼합성형에 관한 특성

김석호,윤한기,여홍태 東義大學校産業技術開發硏究所 1998 産業技術硏究誌 Vol.12 No.-

For the purpose of recycling the rigid thermosets, this study investigated the film of thermoplastic mixed with some weight fraction of rigid phenol in the hot compression molding at temperature of 200℃. The results abtained are as follows; the tensile stress according to the weight fraction of phenol particle is linearly proportional to the strain upto 2% of strain, the more the grain fraction of phenol is, the smaller the stress and strain is at frature, in case of the same weight fraction of phenol, the stress and strain of large grain is larger than those of small grain.

한국인 관상동맥의 변화양상에 대한 형태학적 연구

권태정,이상용,이한영,고영창,권기석,조재홍,김태공,김유훈,조갑래,서중석,이원태 內務部 國立科學搜査硏究所 2001 國立 科學 搜査 硏究所 年報 Vol.33 No.-

방사선조사가 Streptococcus mutans에 미치는 영향

안기동,김규태,최용석,황의환 대한구강악안면방사선학회 2007 Imaging Science in Dentistry Vol.36 No.1

Purpose : To observe direct effect of irradiation on cariogenic Streptooccus mutans. Materials and Methods : S. mutans GS5 was exposed to irradiation with a single absorbed dose of 10, 20, 30, and 40 Gy. Viability and changes in antibiotic sensitivity, morphology, transcription of virulence factors, and protein profile of bacterium after irradiation were examined by pour plate, disc diffusion method, transmission electron microscopy, RT-PCR, and SDS-PAGE, respectively. Results : After irradiation with 10 and 20 Gy, viability of S. mutans was reduced. Further increase in irradiation dose, however, did not affect the viability of the remaining cells of S. mutans. Irradiated S. mutans was found to have become sensitive to antibiotics. In particular, the bacterium irradiated with 40 Gy increased its susceptibility to cefotaxime, penicillin, and tetracycline. Under the transmission electron microscope, number of morphologically abnormal cells was increased as the irradiation dose was increased. S. mutans irradiated with 10 Gy revealed a change in the cell wall and cell membrane. As irradiation dose was increased, a higher number of cells showed thickened cell wall and cell membrane and lysis, and appearance of ghost cells was noticeable. In RT-PCR, no difference was detected in expression of gtfB and spaP between cells with and without irradiation of 40 Gy. In SDS-PAGE, proteins with higher molecular masses were gradually diminished as irradiation dose was increased. Conclusion : These results suggest that irradiation affects the cell integrity of S. mutans, as observed by SDS-PAGE, and as manifested by the change in cell morphology, antibiotic sensitivity, and eventually viability of the bacterium. (Korean J Oral Maxillofac Radiol 2007; 37: 35-43)

水質汚染에 의한 貝類中 重金屬汚染에 관한 國際的 硏究

김형석,김덕만,이기태,Chiba Momoko,Teramoto Keiko 한국환경독성학회 1994 환경독성보건학회지 Vol.9 No.2

The accumulation of heavy metals including Cd, Cu, Mn, Zn and Pb in various organs of shellfish which is the reasonable bio-indicator for hazardous substance contamination on lotic habitats with relatively limited mobility through waterbody was studied. Meretrix petechialis, Scapharca broughtonii, and Scapharca subcerenate from West Coast of Korea and Osaka Bay of Japan were selected to compare heavy metal contamination in adduct muscle, foot muscle, gill, mantle, and visceral organ of marine shellfish. Semisulcospira spp. from various area include West Coast of Korea and Han river were analyzed to compare heavy metal concentration in whole tissues between marine water and fresh water. A regional differences among Hong-chun, Kang-chon, Keum-nahm, Kah-pyung, Seo-rak, and Pal-dang of heavy metal concentration in Semisulcospira gottche was compared. There are significantly differences in mean concentration of Cd, Cu, Mn, Zn, and Pb among organs and species of M. petechialis, S. broughtonii, and S. subcerenate (ANOVA -F=60.31, p<0.001; F=36.88, p<0.001; F=27.78, p<0.001; F=9.39, p<0.001; F=2.91, p<0.001, respectively). The highest mean concentration of Cd with 0.680ppm was observed in gill and the lowest mean concentration of Cd with 0.082ppm was observed in foot muscle. The mean concentration of Cd with 0.349ppm in S. broughtonii was significantly different from other two species with 0.255 and 0.175ppm. Both Cu and Mn were highly accumulated in gill and mantle compare to other organs. Both gill and mantle had significantly different mean Cu concentration with 4.937 and 4.950ppm, respectively compare to both adduct muscle and foot muscle with 2.129 and 2.029ppm, respectively after Duncan's Multiple Range Test. The mean concentration of Cu with 1.900ppm in S. broughtonii was significantly lower then those of other two species. Both Zn and Pb were highly accumulated in gill compare to other organs. The mean concentration of all tested heavy metals except Cu in S. broughtonii were significantly higher than those of other species. There are significantly differences in mean concentration of all tested heavy metal except Cd between whole tissue of marine Semisulcospira spp. and fresh water Semisulcospira spp. Fresh water Semisulcospira spp. had high mean concentrations of Mn, Zn, and Pb while marine Semisulcospira spp. had higher mean concentrations of Cu. The mean concentrations of all tested heavy metals except Pb in Semisulcospira gottche from various area in Han River was significantly different among sites. The mean concentration of Cd in S. gottcheu from Hong-ehun, Cu in S. gottcheu from Kang-chon and Kah -pyung, Mn in S. gottcheu from Kah-pyung and Paldang, and Zn in S. gottcheu from Pal -dang was higher than those of other sites.